Release

Authorization and Release of Liability

Available as PDF (English)  |  Available as PDF (Spanish)


I, the parent or guardian of the child attached to this form, authorizes the participation of my child in KiDs Beach Club®, Inc. Beach Club Program (herein being referred to a KBC, the “Program”) of the sponsoring Church. My child will participate in the Beach Club Program denoted on the registration form.

I understand that this Program is a non-profit Christian after-school ministry program for youth and that my child’s participation is voluntary and not essential to completion of requirements of any program, school or government agency. I understand that the Program is conducted by the Church and its volunteers and staff, including parents of other participating children. I also understand that the Church is solely responsible for all aspects of the Program including selection and supervision of all persons conducting the Program, and that KBC is not responsible for the Program or selecting and supervising persons conducting the Program. I further understand and agree that my child’s participation in activities of the Program necessarily involves the risk of injury and even death from various causes, including but not limited to accidents, falls, strenuous and prolonged physical activity, dehydration, illness, collision or dispute with other participants, weather related injuries, playing area and equipment defects, and negligence of volunteers. On behalf of my child, me, and my family, I assume these risks. In consideration of the privilege of my child’s participation in the Program, and on behalf of my child and me as parent/guardian, I hereby release, discharge, hold harmless and indemnify, and covenant not to sue, the Church and KBC, and all of the Church’s and KBC’s directors, officers, elders, trustees, deacons, employees, volunteers, insurers, agents and representatives, and all other persons associated with the Program (including without limitation any other participating churches, sponsors, parents, vendors, and other game and event workers, officials, and organizations) as to any and all claims of my child, me and other family members for personal injuries suffered by my child, property damage, medical expenses, and economic loss arising directly or indirectly out of my child’s participation in the Program, and any first aid, medical care or treatment provided to my child in the event my child is injured or becomes ill while participating in Program activities, and excepting claims that may not be released under applicable law. This Release of Liability shall be as broadly construed as allowed by law to include all claims and rights that the child, that I as parent/guardian, and that other family members may have. I am a legally responsible parent or guardian of my child. If any provision of this Release of Liability is deemed invalid, the remaining provisions shall remain in full force and effect. This Release of Liability shall be binding on me, my family, heirs, next of kin, legal representatives, beneficiaries, successors and assigns I hereby authorize the Church and KBC to use, reproduce, distribute, display, and to license others to use, reproduce, distribute, and display, my child’s image, and photograph, as well as any video, digital, or audio recording or reproduction, in connection with external and internal communications of the Church and KBC for the sole purpose of advancing KBC programs. I acknowledge and consent that registration will allow KBC to obtain access to personal information regarding me and my child participant. I agree that KBC may use such personal information in a manner consistent with KBC’s Conditions of Use and Privacy as amended from time to time. I further understand that the current version of the KBC Privacy Policy may be found at www.kidsbeachclub.org/privacy-policy.

 

 

Consent to Medical Treatment

In the event my child is injured or becomes ill in Program activities, and if I, the parent or guardian of the above-named child, am not present to make medical decisions, I hereby authorize the Church, its staff, volunteers including volunteer parent participants, to arrange for and consent on my behalf to emergency medical and dental care and treatment, including tests and radiological exams, and surgery, and hospital care and treatment, and to consent to medications for pain and other conditions as prescribed by medical personnel attending my child. I am responsible for payment of any medical charges or expenses not covered by my insurance or the insurance applicable to my child (if any). My signature on the parent permission/child registration form indicates that all information provided in this form is true and accurate, and that I fully agree to all statements made on the form, including but not limited to the Authorization and Release of Liability, Medical Conditions, and Consent to Medical Treatment. My signature also indicates that all legal guardians are aware and consensual with the participation of the child named on the registration form.